Accommodative intraocular lens for producing a restoring force

Abstract

The invention relates to an accommodative intraocular lens (1) for insertion in the capsular bag (4) of an eye, having a first lens part (2), including a first membrane (5) and an optical axis (16), and a second lens part (3) which can be detachably coupled to the first lens part, whereby the intraocular lens can be transferred to a coupled state.

Description

[0001] The invention relates to an accommodative intraocular lens for generating a restoring force. DE 10 2020 123 518 B3 discloses an accommodative intraocular lens. US 2020 / 0046490 A1 discloses a dual-optical, curvature-changing accommodative intraocular lens. US 2018 / 0161151 A1 discloses branched haptic alignment actuators for accommodative intraocular lenses. DE 603 ​​07 816 T2 discloses an accommodative intraocular lens. WO 2020 / 025325 A1 discloses an accommodative intraocular lens.

[0002] With a natural lens, it is possible to see objects both near and far. This is made possible by the ability to change the shape of the lens, and thus its refractive power. The lens is contained within a capsular bag suspended by zonular fibers, which in turn are connected to a ciliary muscle. When the ciliary muscle relaxes, the zonular fibers tighten, stretching the capsular bag. The change in shape of the capsular bag causes a soft lens to change its shape as well. As the capsular bag stretches, the lens becomes increasingly flattened. This changes the refractive power of the lens. A flattened lens results in less refractive power, enabling sharp distance vision. This process is reversible; when the ciliary muscle is tense, the zonular fibers relax and the capsular bag is less stretched.This causes the lens of the eye to take on a more curved shape, achieving a higher refraction. This makes it possible to see near objects clearly. This variation in the plane of focus is called accommodation.

[0003] It is normal for the lens of the eye to lose elasticity with age. The lens is then less able to change its shape in response to contraction of the ciliary muscle. This makes focusing on close objects increasingly difficult. This condition is called presbyopia. Wearing glasses or contact lenses can compensate for the lack of refractive power. However, with age, the lens of the eye becomes increasingly inelastic and hard, and can also become cloudy. In medicine, this condition of the lens is referred to as a cataract. Eyeglass lenses cannot compensate for the effects of clouding of the lens, so it has become common practice to surgically remove the clouded lens. For this procedure, a needle vibrating with ultrasound is inserted into the eye and shatters the hard, clouded lens into small particles.This procedure is called phacoemulsification. Following phacoemulsification, the particles are suctioned out until the capsular bag is free of the natural lens. To restore good vision, an artificial lens is then implanted into the capsular bag. This artificial lens is called an intraocular lens.

[0004] The artificial lens is typically a lens with a single focal point (monofocal), meaning that after implantation of an artificial lens, a patient requires glasses or contact lenses to see clearly both at distance and up close. However, there are also considerations for designing the artificial lens to allow accommodation with a changing focal plane. Such an artificial lens is also called an accommodative intraocular lens. Contracting or relaxing a ciliary muscle should make it possible to change the shape of the intraocular lens and thus its refractive power. It would be desirable to create an artificial lens that also has similar mechanical properties to the natural lens.

[0005] US 2010 / 0 179 653 A1 discloses an accommodating intraocular lens. US 2014 / 0 368 789 A1 discloses an adaptive lens system.

[0006] The object of the invention is therefore to create an accommodative intraocular lens which has similar mechanical properties to a natural eye lens.

[0007] A first accommodative intraocular lens according to the invention for insertion into the capsular bag of an eye comprises a first lens part and a second lens part. The first lens part comprises a light-transparent lens component having a distal surface of the lens component and a proximal surface of the lens component. Furthermore, the first lens part comprises a light-transparent first membrane, which is arranged adjacent to the distal surface of the lens component and, together with the lens component, defines a cavity. Furthermore, the first lens part has an optical axis. The second lens part can be detachably coupled to the first lens part, whereby the intraocular lens can be brought into a coupled state in which the second lens part is arranged on a distal side of the first lens part and is configured to deform the first membrane by longitudinally displacing the second lens part parallel to the optical axis.The second lens part has a first component that forms a distal end of the second lens part and has an axial through-hole of the first component, and a second component that is configured to deform the first membrane and has an axial through-hole of the second component. The optical axis extends through the axial through-hole of the first component and through the axial through-hole of the second component. The first component and the second component are firmly connected to one another at their ends, which, in the coupled state, are arranged outward in a radial direction with respect to the optical axis, wherein the first component and the second component are configured to displace towards one another with increasing stretching of the capsular bag and thereby generate a restoring force.

[0008] A second accommodative intraocular lens according to the invention for insertion into the capsular bag of an eye comprises a first lens part and a second lens part. The first lens part comprises a light-transparent lens component having a distal surface of the lens component and a proximal surface of the lens component. Furthermore, the first lens part comprises a light-transparent first membrane arranged adjacent to the distal surface of the lens component and, together with the lens component, defining a cavity. Furthermore, the first lens part has an optical axis.The second lens part can be detachably coupled to the first lens part, whereby the intraocular lens can be brought into a coupling state in which the second lens part is arranged on a distal side of the first lens part and is configured to deform the first membrane by longitudinally displacing the second lens part parallel to the optical axis. The second lens part has a first component that forms a distal end of the second lens part and has an axial through-hole of the first component, and a second component that extends in the direction of the optical axis at least as far as the lens component and has an axial through-hole of the second component. The optical axis extends through the axial through-hole of the first component and through the axial through-hole of the second component.The first component and the second component are firmly connected to one another at their ends, which in the coupling state are arranged outwardly in a radial direction with respect to the optical axis, wherein the first component and the second component are configured to shift towards one another with increasing stretching of the capsular bag and thereby generate a restoring force.

[0009] The arrangement comprising the lens component, the cavity, and the first membrane is configured to produce an optical image, whereby the first lens part has the optical axis. To insert the intraocular lens into the capsular bag of an eye, an incision is made in the capsular bag. First, the first lens part and then the second lens part are inserted into the capsular bag via the incision. The second lens part is positioned in the capsular bag in such a way that the intraocular lens enters the coupled state. Because the membrane is deformed by the longitudinal displacement of the second lens part, the membrane undergoes a change in its radius of curvature. By changing its radius of curvature, the membrane changes its refraction, allowing the eye to accommodate objects at a distance or close up.

[0010] The restoring force arises because when a ciliary muscle relaxes, the capsular bag experiences increasing stretching. As a result, a front region of the capsular bag presses on the first component. In the first intraocular lens according to the invention, a rear region of the capsular bag presses on the second component via the first lens part. In the second intraocular lens according to the invention, the second component contacts the rear region of the capsular bag, so that the rear region of the capsular bag presses directly on the second component. As a result, the first component and the second component shift towards each other, creating the restoring force. The restoring force means that the capsular bag is stretched less when the ciliary muscle is tensed again after relaxation. As a result, the intraocular lens has similar mechanical properties to a natural lens.

[0011] For the second intraocular lens according to the invention, it is preferred that the first component has a cylindrical portion which, in the coupling state, forms the radially inner end of the first component and which contacts the first lens part.

[0012] For the second intraocular lens according to the invention, it is preferred that the second component extends in the axial direction at least as far as a proximal side of the first lens part. Furthermore, for the second intraocular lens according to the invention, it is preferred that a proximal surface of the second component is convexly curved. This allows the posterior region of the capsular bag to conform well to the second component, thus preventing injury to the tissue of the posterior region of the capsular bag by the second component.

[0013] For both intraocular lenses according to the invention, it is preferred that the first component and / or the second component have a maximum extension of at least 8.5 mm in the radial direction. This makes it possible to laterally expand and keep the capsular bag open both in an extended and unextended state. This can protect the tissue of the capsular bag from injury. The maximum extension can, for example, be 10.0 mm.

[0014] It is preferred for both intraocular lenses according to the invention that the lens component is a second membrane or an optical body.

[0015] The elastic modulus of the first component and the second component is preferably between 1.5 MPa and 5.0 MPa for both intraocular lenses according to the invention. The elastic modulus of the first membrane and / or the second membrane is preferably a maximum of 3 MPa, in particular between 1.5 MPa and 2.0 MPa, for both intraocular lenses according to the invention.

[0016] For both intraocular lenses according to the invention, it is preferred that the second lens part comprises a further lens. It is particularly preferred that an optical axis of the further lens essentially coincides with the optical axis of the first lens part. The further lens can, for example, be toric. This can advantageously correct astigmatism. It is also conceivable that the further lens is not accommodative.

[0017] A distal surface of the first component is preferably convexly curved for both intraocular lenses according to the invention. As a result, the surface of the first component that contacts the capsular bag has the same shape as the capsular bag. This allows the front region of the capsular bag to conform particularly well to the first component, thus preventing injury to the capsular bag tissue by the first component.

[0018] For both intraocular lenses according to the invention, the first component and / or the second component preferably have a plurality of radial through-holes through which a fluid can flow from a radially inner side of the second lens part to a radially outer side of the second lens part. By allowing more flow through the radial through-holes in the capsular bag than without the radial through-holes, the likelihood of a secondary cataract can be reduced.

[0019] For both intraocular lenses according to the invention, it is preferred that the second lens part has a plurality of feet which, in an axial region, form the radially outer end of the second lens part, protrude in a proximal direction from the remaining second lens part, and are arranged adjacent to one another in a circumferential direction with respect to the optical axis. By means of the feet, a particularly large area of ​​the capsular bag can be spanned, and because the feet are arranged at a distance from one another, flow between the feet is possible, thereby reducing the likelihood of a cataract occurring. The feet are particularly preferably configured to hold the first lens part, in particular the lens component, in the coupled state and thus to center the first lens part with respect to the second lens part.For this purpose, the feet can, for example, be designed to be rotationally symmetrical with respect to the optical axis.

[0020] The invention is explained in more detail below with reference to the attached schematic drawings. Figure 1 a longitudinal section through a first embodiment of the accommodative intraocular lens according to the invention in a capsular bag which is in a non-stretched state, Figure 2 a longitudinal section through the intraocular lens according to Figure 1 , with the capsular bag in a stretched state, Figure 3 a longitudinal section through a second embodiment of the accommodative intraocular lens according to the invention and Figure 4 a longitudinal section through a third embodiment of the accommodative intraocular lens according to the invention.

[0021] Figures 1 and 2show that according to a first embodiment of the accommodative intraocular lens 1 for insertion into the capsular bag 4 of an eye, the intraocular lens 1 has a first lens part 2 and a second lens part 3. The first lens part 2 has a light-transparent lens component 7, which has a distal surface 13 of the lens component 7 and a proximal surface 14 of the lens component 7, a light-transparent first membrane 5, which is arranged adjacent to the distal surface 13 of the lens component 7 and, together with the lens component 7, delimits a cavity 10, and an optical axis 16.The second lens part 3 can be detachably coupled to the first lens part 2, whereby the intraocular lens 1 can be brought into a coupling state in which the second lens part 3 is arranged on a distal side 17 of the first lens part 2 and is configured to deform the first membrane 5 by longitudinally displacing the second lens part 3 parallel to the optical axis 16. The second lens part 3 has a first component 21, which forms a distal end of the second lens part 3 and has an axial through-hole 22 in the first component 21, and a second component 23, which extends in the axial direction 54 with respect to the optical axis 15 at least as far as the lens component 7 and has an axial through-hole 24 in the second component 23. The optical axis 16 extends through the axial through-hole 22 of the first component 21 and through the axial through-hole 24 of the second component 23.The first component 21 and the second component 23 are firmly connected to one another at their ends, which in the coupling state are arranged outwardly in a radial direction 55 with respect to the optical axis 16, wherein the first component 21 and the second component 23 are configured to shift towards one another with increasing stretching of the capsular bag 4 and thereby generate a restoring force.

[0022] How it turns out Figures 3 and 4As can be seen, according to a second and third embodiment of an accommodative intraocular lens 1 for insertion into the capsular bag 4 of an eye, the intraocular lens 1 has a first lens part 2 and a second lens part 3. The first lens part 2 has a light-transparent lens component 7, which has a distal surface 13 of the lens component 7 and a proximal surface 14 of the lens component 7, a light-transparent first membrane 5, which is arranged adjacent to the distal surface 13 of the lens component 7 and together with the lens component 7 delimits a cavity 10, and an optical axis 16.The second lens part 3 can be detachably coupled to the first lens part 2, whereby the intraocular lens 1 can be brought into a coupling state in which the second lens part 3 is arranged on a distal side 17 of the first lens part 2 and is configured to deform the first membrane 5 by longitudinally displacing the second lens part 3 parallel to the optical axis 16. The second lens part 3 has a first component 21, which forms a distal end of the second lens part 3 and has an axial through-hole 22 in the first component 21, and a second component 23, which is configured to deform the first membrane 5 and has an axial through-hole 24 in the second component 23. The optical axis 16 extends through the axial through-hole 22 of the first component 21 and through the axial through-hole 24 of the second component 23.The first component 21 and the second component 23 are firmly connected to one another at their ends, which in the coupling state are arranged outwardly in a radial direction 55 with respect to the optical axis 16, wherein the first component 21 and the second component 23 are configured to shift towards one another with increasing stretching of the capsular bag 4 and thereby generate a restoring force.

[0023] In Figure 1 the capsular bag 4 is shown in an unstretched state in which zonular fibers 15 attached to the capsular bag 4 are relaxed. Figure 2shows that the relaxation of a ciliary muscle (not shown) tightens the zonular fibers 15, causing the capsular bag 4 to enter an extended state. As a result, a front region 52 of the capsular bag 4 presses on the first component 21. A rear region 53 of the capsular bag 4 presses on the second component 23. According to the first embodiment, the rear region 53 of the capsular bag 4 presses directly on the first component 21, and according to the second embodiment and the third embodiment, the rear region 53 presses indirectly via the first lens part 2 on the second component 23. As a result, the first component 21 and the second component 23 are displaced towards one another, thereby generating the restoring force. If the zonular fibers 15 relax again due to the contraction of the ciliary muscle, the capsular bag 4 returns to the unstretched state due to the restoring force. Figure 1 .

[0024] How it turns out Figures 1 and 2As can be seen, according to the first embodiment, the first component 21 can have a cylindrical portion 26 which, in the coupled state, forms the inner end of the first component 21 in the radial direction 55 and which contacts the first lens part 2. The cylindrical portion 26 can protrude from the remaining first component 21 in an axial direction 54 with respect to the optical axis 16 toward the first lens part 2.

[0025] Figures 1 and 2 show that, according to the first embodiment, the second component 23 can extend in the coupling state in the axial direction 54 at least as far as a proximal side 8 of the first lens part 2. Furthermore, it can be seen that a proximal surface 44 of the second component 23 can be convexly curved.

[0026] According to the second embodiment and the third embodiment, the second component 23 may have a disc-shaped portion 31 which contacts the first lens part 2 and which delimits the axial through-hole 24 of the second component 23, see Figures 3 and 4 In the coupled state, the disk-shaped portion 31 and the first component 21 can define a gap 25 of the second lens part 3 in the axial direction 54. The gap 25 can be open inwardly in the radial direction.

[0027] For all embodiments, the first component 21 and / or the second component 23 can extend to an equator 51 of the capsular bag 4, wherein the equator 51 separates a front region 52 of the capsular bag 4 from a rear region 53 of the capsular bag. For this purpose, the first component 21 and / or the second component 23 can have a maximum extension of at least 8.5 mm in the radial direction 55. The maximum extension in the radial direction 55 can, for example, be a maximum of 10.0 mm.

[0028] How it turns out Figures 1 to 4As can be seen, the first lens part 2 can have a plurality of bending elements 9, which are arranged on the distal surface 11 of the first membrane 5 and which are spaced apart from one another in the circumferential direction 56 with respect to the optical axis 16. In the first embodiment, the bending elements 9 are in contact with the first component 21, in particular with the cylindrical section 26. In the second and third embodiments, the bending elements 9 are in contact with the second component 23.

[0029] Figures 1 and 2 show that the lens component 7 can be, for example, an optical body 8. Figures 3 and 4 show that the lens component 7 can be, for example, a second membrane 6.

[0030] The elastic modulus of the first component 21 and the second component 23 can be from 1.5 MPa to 5.0 Pa. The elastic modulus of the first membrane 5 and / or the second membrane 6 can be a maximum of 3 MPa, in particular from 1.5 MPa to 2 MPa.

[0031] Figures 1 and 2 show that the second lens part 3 can have a further lens 27. In the coupled state, the optical axis of the further lens 27 can essentially coincide with the optical axis 16 of the first lens part 2. The further lens 27 can, for example, be toric. This makes it possible to correct astigmatism using the further lens. It is also conceivable that the further lens 27 is not accommodative, i.e., unlike the first lens part 2, it cannot change its refractive power.

[0032] Out of Figures 1 to 4 It can be seen that a distal surface 41 of the first component 21 can be convexly curved.

[0033] Figure 4 shows that the first component 21 and / or the second component 23 can have a plurality of radial through-holes 28, via which a liquid can flow from an inner side of the second lens part 3 in the radial direction 55 to an outer side of the second lens part 3 in the radial direction 55.

[0034] In addition, Figure 4that the second lens part 3 can have a plurality of feet 29, which in an axial region form the outer end of the second lens part 3 in the radial direction 55, protrude in a proximal direction from the remaining second lens part 3 and are arranged adjacent to one another in a circumferential direction 56 with respect to the optical axis 16. The feet 29 can be configured to hold the first lens part 2, in particular the lens component 7, in the coupled state and thus to center the first lens part 2 with respect to the second lens part 3. For centering, the feet 29 can be arranged, for example, rotationally symmetrically with respect to the optical axis 16. In order to hold the first lens part 2, the feet 29 can each have a radial projection 30 that projects from the feet 29 in the direction of the optical axis 16.The radial projection 30 can be configured to clamp the first lens part 2, in particular a haptic 19 of the first lens part 2, between the radial projection 30 and the capsular bag 4 in the coupling state. List of reference symbols

[0035] 1 accommodative intraocular lens 2 first lens part 3 second lens part 4 capsular bag 5 first membrane 6 second membrane 7 lens component 8 optic body 9 flexure 10 cavity 11 distal surface of the first membrane 12 proximal surface of the first membrane 13 distal surface of the lens component 14 proximal surface of the lens component 15 zonular fibers 16 optical axis 17 distal side of the first lens part 18 proximal side of the first lens part 19 haptic 21 first component 22 axial through-hole of the first component 23 second component 24 axial through-hole of the second component 25 space 26 cylindrical section 27 further lens 28 radial through-hole 29 base 30 radial projection 31 disc-shaped section 41 distal surface of the first component 42 proximal surface of the first component 43 distal surface of the second component 44 proximal surface of the second component 51 equator of the capsular bag 52 anterior region of the capsular bag 53 posterior region of theCapsular bag 54 Axial direction 55 Radial direction 56 Circumferential direction

Claims

1. Accommodative intraocular lens for insertion into the capsular bag (4) of an eye, having a first lens part (2), which comprises a light-transparent lens component (7) comprising a distal surface (13) of the lens component (7) and a proximal surface (14) of the lens component (7), a light-transparent first membrane (5) arranged adjacent to the distal surface (13) of the lens component (7) and delimiting a cavity (10) together with the lens component (7), and an optical axis (16), and a second lens part (3) which can be detachably coupled to the first lens part (2), whereby the intraocular lens (1) is able to be brought into a coupled state in which the second lens part (3) is arranged on a distal side (17) of the first lens part (2) and configured to deform the first membrane (5) by way of a longitudinal displacement of the second lens part (3) parallel to the optical axis (16), with the second lens part (3) comprising a first component (21), which forms a distal end of the second lens part (3) and has an axial through hole (22) in the first component (21), and a second component (23), which is configured to deform the first membrane (5) and has an axial through hole (24) in the second component (23), with the optical axis (16) extending through the axial through hole (22) in the first component (21) and through the axial through hole (24) in the second component (23), with the first component (21) and the second component (23) being securely connected to one another at their ends which, in the coupled state, are arranged on the outside in a radial direction (55) with respect to the optical axis (16), characterized in that the first component (21) and the second component (23) are configured to be displaced toward one another in the case of increased stretching of the capsular bag (4) and produce a restoring force as a result.

2. Accommodative intraocular lens for insertion into the capsular bag (4) of an eye, having a first lens part (2), which comprises a light-transparent lens component (7) comprising a distal surface (13) of the lens component (7) and a proximal surface (14) of the lens component (7), a light-transparent first membrane (5) arranged adjacent to the distal surface (13) of the lens component (7) and delimiting a cavity (10) together with the lens component (7), and an optical axis (16), and a second lens part (3) which can be detachably coupled to the first lens part (2), whereby the intraocular lens (1) is able to be brought into a coupled state in which the second lens part (3) is arranged on a distal side (17) of the first lens part (2) and configured to deform the first membrane (5) by way of a longitudinal displacement of the second lens part (3) parallel to the optical axis (16), with the second lens part (3) comprising a first component (21), which forms a distal end of the second lens part (3) and has an axial through hole (22) in the first component (21), and a second component (23), which extends at least as far as the lens component (7) in the axial direction (54) with respect to the optical axis (16) and has an axial through hole (24) in the second component (23), with the optical axis (16) extending through the axial through hole (22) in the first component (21) and through the axial through hole (24) in the second component (23), with the first component (21) and the second component (23) being securely connected to one another at their ends which, in the coupled state, are arranged on the outside in a radial direction (55) with respect to the optical axis (16), characterized in that the first component (21) and the second component (23) are configured to be displaced toward one another in the case of increased stretching of the capsular bag (4) and produce a restoring force as a result.

3. Intraocular lens according to Claim 2, wherein the first component (21) comprises a cylindrical portion (26) which, in the coupled state, forms the inner end of the first component (21) in the radial direction (55) and which is in contact with the first lens part (2).

4. Intraocular lens according to Claim 2 or 3, wherein the second component (23), in the coupled state, extends at least as far as a proximal side (8) of the first lens part (2) in the axial direction (54), in particular wherein a proximal surface (44) of the second component (23) has a convexly curved embodiment.

5. Intraocular lens according to any of Claims 1 to 4, wherein the first component (21) and / or the second component (23) have a maximum extent of at least 8.5 mm in the radial direction (55).

6. Intraocular lens according to any of Claims 1 to 5, wherein Young's modulus of the first component (21) and of the second component (23) is from 1.5 MPa to 5.0 MPa.

7. Intraocular lens according to any of Claims 1 to 6, wherein the second lens part (3) comprises a further lens (27), in particular wherein the further lens (27) has a toric and / or non-accommodative embodiment.

8. Intraocular lens according to any of Claims 1 to 7, wherein a distal surface (41) of the first component (21) has a convexly curved embodiment.

9. Intraocular lens according to any of Claims 1 to 8, wherein the first component (21) and / or the second component (23) have / has a plurality of radial through holes (28), through which a liquid is able to flow from an inner side of the second lens part (3) in the radial direction (55) to an outer side of the second lens part (3) in the radial direction (55).

10. Intraocular lens according to any of Claims 1 to 9, wherein the second lens part (3) comprises a plurality of feet (29) which, in an axial region, form the outer end of the second lens part (3) in the radial direction (55), protrude from the remaining second lens part (3) in a proximal direction and are arranged adjacent to one another in a circumferential direction (56) with respect to the optical axis (16), in particular wherein the feet (29) are configured to retain the first lens part (2), in particular the lens component (7), in the coupled state and consequently center the first lens part (2) in relation to the second lens part (3).

Images